Don't Want to Increase Size, But Want to Gain Fullness During Breast Lift, Do I Need Implants as Well? (photo)

I am 33 years old and done having children. I am considering having a breast lift done but am concerned with how they will turn out after surgery. Ideally I would like them to be lifted and rounder. I am currently a size 32D-DD and dont feel like I want to add more sizewise, but I worry that if I do not add an implant that I will be left with flat looking breasts. I would like to not have the T shapped/lollipop scar, is that an option for me? Will I need an implant?

Doctor Answers 29

Auto Augmentation Mastopexy

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If a woman has full breasts and wants to have perkier, more youthful looking breasts without adding volume, it is possible to lift the breast tissue and to reposition some breast tissue to create upper pole fullness without adding breast implants.

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Breast Lift With or Without Implants

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These are good questions that are very common in my practice. First of all you need a full lift. The periareolar or other short scar lifts are not going to allow your surgeon to improve your shape and increase the fullness of your breasts during surgery.

You appear from your pictures to have good breast tissue that will allow you to get a good result with your breast lift. It is possible to give you a full natural appearing breast without the use of implants. In your particular case the full lift you will improve the shape of your breast, the position of your nipple and have a round, full breast.

Especially since you don’t want to be any larger I would not use an implant.

I hope this helps, you look like a great candidate for a breast lift and will likely have a great result!

Breast Lift Without Implants

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Thank you for the photos and questions, Sherrie. I agree with completely. You do not need and should not have a combined mastopexy (lift) and augmentation. You will gain some superior fullness and projection with a vertical lift (less with a Wise pattern). The reason you should not get implants at least initially is studies show that raising your nipple more than 4 cm and then placing an implant at the same sitting can lead to increased complications. I think you will be happy with a lift alone.

Mastopexy without implants

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Dear Sherrie,

you are right: using implants my not be necessary and  may open the door to a whole new set of issues.

nevertheless, a " lolipop scar " breast lift may be your best option with an internal reshaping of the breast tissue. that vertical T of the lolipop is essential in obtaining a nice conical breast, with a projected nipple. You do not need an " anchor scar " lift.

those scars are the trade - off to the lift, and will be included in all bras and bathing suits.

you still have to understand you will go down one cup size, since the breast tissue will be compressed and reshaped, and skin will be cut off. If you are a DD/ D cup, you will go down to a full C / small D.

Good luck,

Florence Mussat, MD


Florence Mussat, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 44 reviews

Breast fullness and firmness after lift usually requires an implant

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Thank you for your question.  A breast lift alone will certainly improve the looks and natural feel of your breasts.

However in my experience a breast lift alone even with adequate breast tissue often produces a "jiggly" breast and does not feel firm.  This is best corrected with a breast implant.

However I agree with all the other surgeons that you should have the breast lift alone first.  You may be perfectly happy with the appearance and feel of your breasts.  If not to you can always have a breast augmentation at a later date after 6 months postop.

Upper pole fullness can be obtained without implants

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A full breast size in the D to DD range with firm breast tissue can produce a beautiful breast shape with excellent upper pole fullness without implants.

We commonly use the breast tissue itself forming an "internal bra" (this procedure was also referred to as "laser bra" in the past) suspending the breast with multiple sutures and forming a full and supported shape.  With abundance of breast tissue to work with, implants are not necessary and a natural, round shape can be obtained predictably.

If a further increase in upper pole fullness is desired later, fat transfer can provide an excellent means of further increase and control over cleavage as well.  The scar pattern is dictated by the exact shape desired in the end.

Mario Diana, MD
Plano Plastic Surgeon

Upper Chest Fullness With a Breast Lift

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Dear Sherrie, Thank you for your photos and question.To raise breast volume to the upper chest will significantly improve your shape.  You do not need an implant in my opinion.  Implants used for upper pole fullness often drop over time and do not gived the intended effect  You will however need removal of extra skin and rearrangement of your breast tissue.  Doing that requires incisions , which means that you will need to think that the improved shape is worth the tradeoff of scars. Good luck! 

Mary Lee Peters, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 117 reviews

Don't Want to Increase Size, But Want to Gain Fullness During Breast Lift, Do I Need Implants as Well?

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Thank you for your question and photos.

There are several variables to be considered when answering this question. It is always difficult to make a diagnosis on photos alone, but you do appear to be a good candidate for a breast lift with implants. When you meet with a board certified plastic surgeon, they will perform a set of measurements that will help determine whether or not a lift is necessary and what approach they will take. This will determine the type of incisions you will have. Another variable that needs to be discussed is what you are wanting. If you are wanting a fuller upper pole to your breast, then an implant will be necessary.  If you are just wanting the breasts to be a little perkier and don't mind the size, then only a lift is necessary. And to have the nipple in proper position over the implant, may require a lift. I hope this is helpful

Jon Kurkjian, MD
Fort Worth Plastic Surgeon
5.0 out of 5 stars 54 reviews

Breast Lift alone, versus a Breast Lift/Augmentation

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From your images it appears that you have sufficient tissue/fullness to avoid an implant.  This Breast Lift alone will be a dramatic improvement to your overall shape, with a much enhanced upper pole fullness/cleavage.

Best wishes,

Sergio Maggi, MD, FACs

Director- Austin Plastic Surgery Center

Implants aren't always necessary

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When we perform a breast lift or mastopexy, we use any of several different techniques to remove excess skin from the breasts. This is very useful when the breast has sagged and the nipple has descended below the breast crease, and can definitely perk up your breasts and improve their shape all by itself without the need for an augmentation. However, if the breasts have deflated over time but there is little or no sagging, an augmentation would fill you out nicely.

In your case, you sound satisfied with your current size, so an augmentation might not be necessary at all. However, in order to determine if a certain procedure is right for you or not, a consultation with a doctor is always the best option by far.

As for scarring, a word of advice: Everyone scars differently. Scars themselves change and go through a process that takes up to one year. Scarring also depends on the type of lift that is needed; for example, a lollipop lift will have a more visible scar than a donut lift. However, the vast majority of my patients are so grateful at the improved shape, contour and nipple placement of their breasts that the feeling of gratitude makes the scar seem insignificant in comparison. It’s a personal decision and you have to ask yourself whether the benefit of the procedure result will outweigh the scar.

I hope that answers your question on breast lifts. Keep doing the research you are doing - I always say the best patients are informed patients.

Thank you for reading and best of luck on your journey!

William Rahal, MD
Beverly Hills Physician
5.0 out of 5 stars 73 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.